Abstract

ACUTE ENCEPHALITIS SYNDROME (AES) ASSOCIATED WITH SOCIOCULTURAL AND ENVIRONMENTAL RISK FACTORS IN INFANTS/CHILDREN OF MUZAFFARPUR, BIHAR- HOSPITAL-BASED, PROSPECTIVE STUDY

Author(s): Sudhir, Sanjeev Kumar, Madhav Sharan Prasad

BACKGROUND Acute encephalitis syndrome is a group of clinical neurologic manifestation caused by wide range of viruses, bacteria, fungus, parasites, spirochetes, chemicals and toxins. According to AES guidelines- Acute encephalitis syndrome due to unknown agent is defined as a suspected case in which no diagnostic testing is performed or in which testing was performed, but no aetiological agent was identified or in which the test results were indeterminate. Acute encephalitis syndrome in children is due to interaction of several factors in combination. The aim of the study is to evaluate the sociocultural and environmental factors, which plays a major role in AES. MATERIALS AND METHODS The study design was non-interventional, hospital-based, prospective study. The study was conducted at Paediatric Department of S.K.M.C.H., Muzaffarpur, Bihar, over a period of January 1, 2015, to July 31, 2017. Infants/children admitted in S.K.M.C.H., Muzaffarpur, were included in study. All defined cases according to AES guidelines were included and 92 infants/children were selected. Percentage, proportion and Chi-square test were performed for statistical analysis. RESULTS Among 92 selected infants/children, AES was highest in rural area, 80 (86.95%). The seasonal incidence of AES was March to July in which highest incidence was found in June, 63 (68.47%). Highest incidence of AES was seen between 1-5 years of age. There was significant statistical association among age of children and AES. AES was more common in male than female. AES was highest in dwellers of kachcha (mud) house. AES was highest, 90 (97.82%) among children of labour/farmer. AES was highest, 90 (97.82%) in which mother was illiterate. Incidence of AES was highest in Hindu religion. All AES, 92 (100%) was seen in malnourished/undernourished children. CONCLUSION Sociocultural and environmental factors were the major determinant risk factors for AES. Among these, malnutrition/under nutrition was the commonest risk factor followed by maternal illiteracy, occupation (labour and farmer), Hindu religion, age between 1-5 years, seasonal variation, March to July, mostly in June, higher in male children, lower housing standard and formula feeding practice. Higher incidence of these contributing factors illustrates the government and other health care providers to strengthen the surveillance of morbidity and mortality due to AES and make strategies for prevention, control and reduction of morbidity and mortality due to AES.